Eficacia del Tofacitinib y Baricitinib en el tratamiento de artritis reumatoide: revisión sistemática

Abstract

Introduction: Rheumatoid arthritis is a chronic condition that significantly impacts patients’ quality of life. The development of Janus kinase inhibitors, such as tofacitinib and baricitinib, represents an effective therapeutic alternative. However, it is necessary to analyze the available evidence to determine their efficacy and safety. Methods: A systematic literature review was conducted from January 2010 to June 2024, following PRISMA guidelines. The search was performed in PubMed, Scopus, Cochrane Library, and ClinicalTrials.gov, using MeSH terms related to tofacitinib, baricitinib, and rheumatoid arthritis. Randomized clinical trials, comparative studies, and systematic reviews that evaluated clinical efficacy, as expressed by remission, DAS28, and ACR responses, were included. Quality assessment was performed using NHLBI criteria, and risk of bias was assessed using the RoB 2 tool. Results: A total of 45 studies were identified, of which 34 were selected after applying eligibility criteria. Finally, 17 studies published between 2010 and 2024 met the specific objectives, highlighting adequate methodological quality and a low risk of bias in key domains such as random sequence generation and intervention blinding. Relevant outcomes included significant clinical response rates (ACR20) and sustained improvements in the DAS28 scores; however, limitations remain regarding the clarity of adverse event reporting and loss to follow-up. Conclusion: Both tofacitinib and baricitinib are effective therapeutic alternatives for the management of rheumatoid arthritis, with consistent evidence of clinical improvement in standardized parameters.